达格列净治疗2型糖尿病的效果分析

doi:10.3760/cma.j.issn.1007-1245.2022.11.023

摘要/Abstract

摘要： 目的　观察达格列净治疗2型糖尿病（T2DM）对患者肾功能及糖脂代谢水平的影响。方法　本研究为前瞻性研究。选取2019年7月至2021年7月济南市第二人民医院收治的T2DM患者86例为研究对象，按数字随机表法分为对照组和观察组，各43例。对照组男25例，女18例，年龄（52.80±5.77）岁；观察组男28例，女15例，年龄（53.19±5.82）岁。对照组给予常规治疗，观察组在对照组基础上给予达格列净治疗。比较两组临床疗效、血糖水平［血糖（FBG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA_1c）］、血脂水平［总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）］、氧化应激指标［丙二醛（MDA）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）］、肾功能指标［尿素氮（BUN）、血肌酐（Scr）、尿微量白蛋白（UMA）］及不良反应发生率。统计学方法采用独立样本t检验、配对t检验、χ²检验。结果　观察组治疗总有效率高于对照组［93.02%（40/43）比74.42%（32/43）］，差异有统计学意义（χ²=5.161，P=0.023）。治疗后，观察组FBG为（6.50±1.33）mmol/L、2hPG为（8.35±1.44）mmol/L、HbA_1c为（6.01±0.54）%、TC为（4.58±0.23）mmol/L、TG为（1.41±0.22）mmol/L、LDL-C为（2.23±0.34）mmol/L、MDA为（3.20±0.33）μmol/L、BUN为（6.33±1.07）mmol/L、Scr为（110.53±18.77）μmol/L、UMA为（10.34±3.21）mg/L，均显著低于对照组的（7.39±1.50）mmol/L、（11.29±2.53）mmol/L、（7.02±1.19）%、（5.23±0.70）mmol/L、（1.95±0.44）mmol/L、（3.31±0.52）mmol/L、（4.50±0.52）μmol/L、（9.86±2.55）mmol/L、（178.41±25.36）μmol/L、（18.55±5.27）mg/L，差异均有统计学意义（t=2.911、6.623、5.068、5.785、7.198、11.399、13.842、8.371、14.108、8.725，均P<0.05）；观察组HDL-C为（1.74±0.65）mmol/L、SOD为（43.96±8.22）U/ml，均显著高于对照组的（1.46±0.53）mmol/L和（36.77±7.03）U/ml，两组比较差异均有统计学意义（t=2.189、4.359，均P<0.05）；两组GSH-Px比较差异无统计学意义（t=0.206，P=0.837）。两组不良反应总发生率［4.65%（2/43）比9.30%（4/43）］比较差异无统计学意义（χ²=0.677，P=0.410）。结论　达格列净治疗T2DM疗效显著，可有效控制血糖水平，改善脂代谢、氧化应激和肾功能。

关键词: 2型糖尿病, 达格列净, 肾功能, 糖脂代谢

Abstract: Objective　To observe the effect of dapagliflozin on renal function and glucose and lipid metabolism in patients with type 2 diabetes mellitus (T2DM). Methods　This was a prospective study. Eighty-six patients with T2DM admitted to Jinan Second People's Hospital from July 2019 to July 2021 were selected as the research objects. They were divided into a control group and an observation group by the random number table method, with 43 cases in each group. The control group had 25 males and 18 females, and they were (52.80±5.77)years old. The obser vation group had 28 males and 15 females, and they were (53.19±5.82)years old, All the patients were given conventional treatment, and the observation group were treated with dapagliflozin on this basis. The clinical effects, the levels of blood glucose [fasting blood glucose (FBG), 2h postprandial blood glucose (2hPG), and glycosylated hemoglobin (HbA_1c)], blood lipids [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)], oxidative stress indicators [malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px)], and renal function indicators [blood urea nitrogen (BUN), serum creatinine (Scr), and urine microalbumin (UMA)], and the incidences of adverse reactions were compared between these two groups. The independent-sample t test, paired t test, and χ² test were applied. Results　The treatment response rate in the observation group was higher than that in the control group [93.02% (40/43) vs. 74.42% (32/43)], with a statistical difference (χ²=5.161,P=0.023). After the treatment, the levels of FBG, 2hPG, HbA_1c, TC, TG, LDL-C, MDA, BUN, Scr, and UMA were (6.50±1.33) mmol/L, (8.35±1.44) mmol/L, (6.01±0.54)%, (4.58±0.23) mmol/L, (1.41±0.22) mmol/L, (2.23±0.34) mmol/L, (3.20±0.33) μmol/L, (6.33±1.07) mmol/L, (110.53±18.77) μmol/L, and (10.34±3.21) mg/L in the observation group, which were significantly lower than those in the control group [(7.39±1.50) mmol/L, (11.29±2.53) mmol/L, (7.02±1.19)%, (5.23±0.70) mmol/L, (1.95±0.44) mmol/L, (3.31±0.52) mmol/ L, (4.50±0.52) μmol/L, (9.86±2.55) mmol/L, (178.41±25.36) μmol/L, and (18.55±5.27) mg/L], with statistical differences (t=2.911, 6.623, 5.068, 5.785, 7.198, 11.399, 13.842, 8.371, 14.108, and 8.725; all P<0.05). The levels of HDL-C and SOD were (1.74±0.65) mmol/L and (43.96±8.22) U/ml in the observation group, which were significantly higher than those in control group [(1.46±0.53) mmol/L and (36.77±7.03) U/ml], with statistical differences (t=2.189 and 4.359; both P<0.05). There was no statistical difference in GSH-Px between the two groups (t=0.206, P=0.837). There was no statistical difference in the incidence of adverse reactions between the two groups [4.65% (2/43) vs. 9.30% (4/43);χ²=0.677, P=0.410]. Conclusion　Dapagliflozin is effective in the treatment of T2DM, and can effectively control blood glucose level and improve lipid metabolism, oxidative stress, and renal function.

Key words: Type 2 diabetes mellitus, Dapagliflozin, Renal function, Glucose and lipid metabolism

嵇高德, 姜莉华, 李群. 达格列净治疗2型糖尿病的效果分析[J]. 国际医药卫生导报, 2022, 28(11): 1579-1583.

Ji Gaode, Jiang Lihua, Li Qun. Effect of dapagliflozin on renal function and glucose and lipid metabolism in patients with type 2 diabetes mellitus[J]. International Medicine and Health Guidance News, 2022, 28(11): 1579-1583.

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